临床分离大肠埃希菌耐消毒剂基因携带情况及5种消毒剂最低抑菌浓度

摘要

Objective To understand the disinfectant resistance of clinically isolated Escherichia coli (E.coli)and carriage of disinfectant resistance genes.Methods Disinfectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,and qacE of 82 isolates of E.coli were detected with polymerase chain reaction (PCR),minimal inhibitory concentra-tions (MICs)were measured with agar dilution methods.Results Among 82 E.coli isolates,positive rates of dis-infectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,qacE,sugE (c )+qacEΔ1 ,and qacE+qacEΔ1 +sugE (c ) were 84.15% (n=69),1 .22% (n=1),76.83% (n=63),73.17 % (n=60),68.29% (n=56),and 59.76% (n=49)respectively.There was no significant differences in carriage status of four disinfectant resistance genes be-tween extended-spectrumβ-lactamases (ESBLs)-producing and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains (all P >0.05);MIC values of benzalkonium chloride,cetylpyridinium chloride,am-monium bromide,and triclosan for 82 isolates of E.coli were all > standard stain;MIC values of chlorhexidine for 32 isolates of E.coli were all > standard stain,for 50 other E.coli strains were all ≤ standard strain.There were no significant difference in MIC values of benzalkonium chloride,cetylpyridinium chloride,ammonium bromide,and triclosan between ESBLs-and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains(all P >0.05);while MIC values of chlorhexidine showed a significant difference (both P <0.05).Conclusion Detection rates of disinfectant resistance gene qacE,qacEΔ1 ,and sugE(c)in E.coli from clinical specimens are high,MICs of disinfectants such as benzalkonium chloride for E.coli are generally higher than standard strain.%目的：了解临床标本分离的大肠埃希菌（E．coli）对常用消毒剂耐药性及其消毒剂耐药基因携带状况。方法采用聚合酶链反应（PCR）对82株 E．coli 耐消毒剂基因 sugE （c）、sugE（p）、qacEΔ1和 qacE 进行检测，琼脂稀释法进行最低抑菌浓度（MIC）测定。结果临床分离的82株 E．coli 中，sugE（c ）、sugE（p ）、qacEΔ1、qacE、sugE （c）＋qacEΔ1、qacE ＋ qacEΔ1＋ sugE （c ）阳性率分别为84．15％（69株）、1．22％（1株）、76．83％（63株）、73．17％（60株）、68．29％（56株）、59．76％（49株）。产超广谱β-内酰胺酶（ESBLs）与非产 ESBLs 菌株，头孢吡肟敏感株与耐药株4种耐消毒剂基因携带情况比较，差异均无统计学意义（均 P ＞0．05）。苯扎氯铵、西吡氯铵、溴化铵及三氯生4种消毒剂对82株E．coli 的 MIC 值均＞标准菌株；氯己定对32株 E．coli 的 MIC 值＞标准菌株，对另外50株 E．coli 的 MIC 值≤标准菌株。苯扎氯铵、西吡氯铵、溴化铵及三氯生对产 ESBLs 和非产 ESBLs 组、头孢吡肟敏感和耐药组的 MIC 值结果比较，差异均无统计学意义（均 P ＞0．05）；而氯己定 MIC 值比较，差异均有统计学意义（均 P ＜0．05）。结论临床送检标本分离的 E．coli 耐消毒剂基因qac E、qacEΔ1和 sugE（c ）检出率高，苯扎氯铵等消毒剂对 E．coli 的 MIC 普遍较标准菌株明显升高。